[Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study]

Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea (Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences (P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

No causal effects between rosiglitazone and cardiovascular disease or risk factors: a Mendelian randomization study

OBJECTIVE

Although many observational studies have shown an association between rosiglitazone and cardiovascular disease (CVD) or risk factors, controversy remains. We conducted a Mendelian randomized (MR) study to explore whether rosiglitazone is causally related to CVDs and risk factors.

PATIENTS AND METHODS

Single-nucleotide polymorphisms associated with rosiglitazone at genome-wide significance were identified from a genome-wide association study of 337,159 European-ancestry individuals. Four treatments with rosiglitazone-associated single-nucleotide polymorphisms associated with a higher risk of CVDs were used as an instrumental variable (IV). Summary-level data for 7 CVDs and 7 risk factors were obtained from UK Biobank and consortia.

RESULTS

We found no causal effects of rosiglitazone, either on CVDs or risk factors. The results were consistent in sensitivity analyses using Cochran's Q test, MR-PRESSO method, leave-one-out analysis and Mendelian randomization-Egger method (MR-Egger), and no directional pleiotropy was observed. Sensitivity analyses confirmed that rosiglitazone was not significantly associated with CVDs and risk factors.

CONCLUSIONS

The findings from this MR study indicate no causal relationship between rosiglitazone and CVDs or risk factors. Hence, previous observational studies may have been biased.

[Establishment of a prognostic model for non-nephrotic membranous nephropathy based on unbalanced data]

Objective: To explore the construction of a machine learning model based on unbalanced data to predict the progression of non-nephrotic membranous nephropathy. Methods: The clinical and pathological data of patients diagnosed with non-nephrotic membranous nephropathy by renal biopsy in Shanxi People's Hospital from January 2018 to December 2021 were retrospectively analyzed.The prediction models were constructed based on logistic regression, support vector machine (SVM) and light gradient boosting machine (lightGBM), respectively. The mixed sampling technology was used to process the unbalanced data, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive performance of the models. Finally, Shapley additive explanation (SHAP) was used to interpret the results of the optimal prediction model. Results: A total of 148 patients were included in the study, including 84 males and 64 females, with a mean age of (47.2±12.5) years. The follow-up time [M(Q₁, Q₃)] was 14(7, 20) months. Twenty-three patients (15.5%) achieved the renal end-point event in the study. The SVM model had the highest AUC (0.868, 95%CI: 0.813-0.925), followed by logistic regression (AUC=0.865, 95%CI: 0.755-0.899) and lightGBM (AUC=0.791, 95%CI: 0.690-0.882). The feature recursive elimination cross validation (RFECV) method based on random forest (RF) and the SHAP plot based on the SVM model showed that immunohistochemistry IgG, total protein (TP), anti-phospholipase A2 receptor (anti-PLA2R), blood chloride and D-Dimer were risk factors affecting the progress of non-nephrotic membranous nephropathy. Moreover, patients with high immunohistochemistry IgG, anti-PLA2R and D-Dimer had an increased risk of achieving the renal end-point event. Conclusion: The SVM model established in this study can effectively predict the progress of non-nephrotic membranous nephropathy, and provide a new method for the early identification of high-risk patients and precision therapy.

Characteristics of atmospheric ice nucleating particles over East Antarctica retrieved from the surface snow

The concentration of ice nucleating particles (INPs) in the atmosphere is critical for understanding cloud microphysics and predicting the climate system. In this study, we collected surface snow samples along a traverse route from the coastal to the inland of East Antarctica to analyze INP concentration and identify its spatial variations using a droplet freezing device. The overall concentration of INPs was found to be considerably low along the route, averaging at 0.8 ± 0.8 × 10⁵ L^-1 in water and 4.2 ± 4.8 × 10^-3 L^-1 in air at -20 °C. Although coastal areas had higher levels of sea salt species compared to inland regions, the concentration of INPs remained consistent along the route suggesting less important origination of INPs from the around ocean. Additionally, the heating experiment revealed the important contribution of proteinaceous INPs indicating the presence of biological INPs (bio-INPs). The fraction of bio-INPs was 0.52 on average at -20 °C and ranged from 0.1 to 0.7 from -30 °C to -15 °C. Finally, we parameterize the atmospheric INP concentrations as a function of freezing temperature which can be useful for modeling INP concentrations in this region.

[A comparison of current guidelines for the management of intrahepatic cholangiocarcinoma worldwide]

Intrahepatic cholangiocarcinoma (ICC) is the second most common human liver malignancy and its incidence rate has been gradually increasing worldwide over the past decades. Surgical resection (R0 resection) is the preferred potentially curative treatment for ICC patients. However, due to its conceal clinical features and high invasiveness, most patients have lost the opportunity for surgical resection at the time of diagnosis. In recent years, with the rapid development of targeted therapy and immunotherapy, which is represented by immune checkpoint inhibitors, clinicians are expected to provide more effective treatment options for patients with mid-stage or advanced ICC. At present, there are still controversial opinions on different guidelines regarding preoperative biliary drainage, the extent of hepatectomy, the definition of R0 resection, the width of the resection margin, lymph node dissection, postoperative recurrence, adjuvant therapy, etc. In this review, 12 guidelines or expert consensus published worldwide from 2012 to 2022 (including 4 Chinese guidelines, 4 European guidelines, 2 American guidelines and 2 Japanese guidelines) were retrieved. Focusing on sorting and comparing the current views on clinical management of ICC in different guidelines, this review aims to provide reference information for ICC clinical management and decision-making.

Combined training prescriptions for improving cardiorespiratory fitness, physical fitness, body composition, and cardiometabolic risk factors in older adults: Systematic review and meta-analysis of controlled trials

Background

Improved physical fitness is important for preventing COVID-19-related mortality. So, combined training can effectively increase peak oxygen consumption, physical fitness, body composition, blood pressure, and the healthrelated characteristics of adults; however, its impact in the elderly remains unclear.

Methods

This systematic review and meta-analysis aimed to evaluate the effects of combined training on older adults. Four electronic databases (PubMed, Scopus, Medline, and Web of Science) were searched (until April 2021) for randomized trials comparing the effect of combined training on cardiorespiratory fitness, physical fitness, body composition, blood pressure, and cardiometabolic risk factors in older adults.

Results

Combined training significantly improved peak oxygen consumption compared to no exercise (WMD = 3.10, 95% CI: 2.83 to 3.37). Combined resistance and aerobic training induced favorable changes in physical fitness (timed up-and-go = -1.06, 30-s chair stand = 3.85, sit and reach = 4.43, 6-minute walking test = 39.22, arm curl = 4.60, grip strength = 3.65, 10-m walk = -0.47, maximum walking speed = 0.15, one-leg balance = 2.71), body composition (fat mass = -2.91, body fat% = -2.31, body mass index = -0.87, waist circumference = -2.91), blood pressure (systolic blood pressure = -8.11, diastolic blood pressure = -4.55), and cardiometabolic risk factors (glucose = -0.53, HOMA-IR = -0.14, high-density lipoprotein = 2.32, total cholesterol = -5.32) in older individuals. Finally, the optimal exercise prescription was ≥ 30 min/session × 50-80% VO2peak, ≥ 3 times/week for ≥ 12 weeks and resistance intensity 70-75% one-repetition maximum, 8-12 repetitions × 3 sets.

Conclusions

Combined training improved VO2peak and some cardiometabolic risk factors in older populations. The dose-effect relationship varied between different parameters. Exercise prescriptions must be formulated considering individual needs during exercise.

[Analysis of perioperative efficacy and safety of cytoreductive surgery in the treatment of colorectal cancer peritoneal metastases]

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.

[Study on the protective effect of cooling the surface of frozen water on renal function in robotic-assisted laparoscopic nephrect]

Objective: To compare the effects of ice water kidney cooling and traditional non-cooling surgery on postoperative renal function in robot-assisted laparoscopic partial nephrectomy, and explore its clinical value in protecting renal function. Methods: A retrospective analysis is conducted on the base of the clinical data of patients undergoing robot-assisted laparoscopic partial nephrectomy in Second Affiliated Hospital of Navy Military Medical University from January to November 2019. A total of 89 cases, of which 21 cases were treated with ice water to cool the kidney surface and block the renal artery during the operation (cooling group); 68 cases only clamp the renal artery (control group). Compare the difference of the operation time, R.E.N.A.L. score, intraoperative blood loss, renal artery block of time,postoperative intestinal recovery time, cut edge positive rate, preoperative and postoperative blood electrolyte levels, the change of blood creatinine and GFR before operation and the first and third months after the operation and other indicators between two groups. Results: All the 89 patients completed the operation normally, and no conversion to open surgery or to general endoscopic surgery. The two groups of patients had statistically significant differences in tumor diameter [7.0(5.5, 8.0) vs 3.8(3.0, 5.0) cm, P<0.001], R.E.N.A.L. score [8.0(6.5, 8.0) vs 6.0(5.0, 8.0), P=0.003], Chloride (Cl^-) in the blood [(103.29±2.81) vs (104.74±2.58) mmol/L, P=0.030], (P<0.05) in the preoperative data. There were significant differences in renal artery occlusion time [20.0(18.5, 27.5) vs 19.0(15.0, 21.0) min, P=0.023] and operation time [168.0(130.0, 182.5) vs 130.0(110.0, 177.5) min, P=0.007] between the two groups (P<0.05). There was no significant difference in the blood creatinine after one or 3 month as well as for the glomerular filtration rate (all P>0.05). After follow-up for 3-24 months, no tumor recurrence or distant metastasis occurred in both groups, and no related complications caused by ice-free Water Cooling Technique in the cooling group. Conclusions: It is safe and effective to apply kidney surface cooling technique with ice water in robot-assisted laparoscopic partial nephrectomy for complex kidney tumor. It can significantly reduce the renal parenchyma warm ischemia injury of renal parenchyma. And it's conducive to the recovery of patients with postoperative renal function, which can maximize the protection of renal function of patients.

[Meta analysis of whether cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can improve survival in patients with colorectal cancer peritoneal metastasis]

Objective: To explore whether the cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) can improve the survival rate of colorectal cancer patients with peritoneal metastasis. Methods: The relevant studies were systematically retrieved from PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP database, and the study of French Elias' team on peritoneal metastasis was retrieved manually. Inclusion criteria: (1) The patients were colorectal cancer peritoneal metastasis. (2) There were CRS+HIPEC treatments (treatment group) and other treatments (control group). (3) Survival analysis data of treatment group and control group were available. (4) Types of studies were randomized controlled trials, cohort studies, or case-control studies. (5) The literature was in Chinese or English. Exclusion criteria: (1) studies without full-text; (2) studies without complete data. The literature screening and data extraction were carried out by two people independently, and the third person decided on the literature with differences. The extracted data included authors, year of publication, number of patients, time of enrollment, time of follow-up, studies design, treatment regimen, hazard ratio (HR) and 95% CI of treatment group and control groups. If the HR and 95% CI of the treatment group and control group were not provided in the literature, Engauge Digitizer 11.1 software was used to extract the time of follow-up and the survival rate at the corresponding time point from the survival curves of both groups, and the HR and 95% CI of both groups were calculated by combining the number of both groups. The quality of study was evaluated by Newcastle-Ottawa scale (NOS) or Cochrane collaboration's tool for assessing risk bias. STATA 15.1 software was used for statistical analysis. HR and 95% CI of both groups were pooled and analyzed. Inter-trial heterogeneity was assessed by Q test and I(2) statistics. When there was no significant heterogeneity (Q test: P≥0.10), fixed-effect model was used for pooled analysis. When significant heterogeneity existed (Q test: P<0.10), random effect model was used for pooled analysis, and subgroup analysis was used to find out the source of heterogeneity. Sensitivity analysis was used to evaluate the stability of the pooled results. Publication bias was assessed by Egger's test and Begg's test (P<0.05 indicated publication bias) and it is reflected by the visual symmetry of Begg's funnel plot on the natural logarithm of HR. Results: A total of 10 studies were enrolled in the meta-analysis, including 1 randomized controlled trial and 9 cohort studies. The risk of bias in 1 randomized controlled trial was uncertain, and 9 cohort studies were all higher than 7 points, indicating high quality literatures. There were 781 patients in treatment group receiving CRS+HIPEC and 2452 patients in control group receiving other treatment, including tumor cytoreductive surgery (CRS), palliative chemotherapy (PC) and intraperitoneal chemotherapy (IPC). The results of pooled analysis by random effect model showed that the OS rate in treatment group was significantly higher than that in control group (HR=0.43, 95% CI: 0.34-0.54), but the heterogeneity of the study was high (P=0.024, I(2)=52.9%). The subgroup analysis of different control treatments showed that the OS rate in treatment group was significantly higher than that in CRS control group (HR=0.63, 95% CI: 0.44-0.90), in PC control group (HR=0.37, 95% CI: 0.32-0.43), in CRS+ IPC control group (HR=0.60, 95% CI: 0.37-0.96), and the heterogeneity of each subgroup was low (CRS control group: P=0.255, I(2)=22.9%; PC control group: P=0.222, I(2)=29.9%; CRS+IPC control group: P=0.947, I(2)=0). Due to the low heterogeneity of subgroups, fixed-effect models were used to pool and analysis. The results of sensitivity analysis revealed that there was little difference between the pooled analysis results after each study was deleted, suggesting that the pooled analysis results were more reliable. Publication bias detection of each study showed Begg's test (P=0.088) >0.05 and Egger's test (P=0.138)>0.05. According to the Begg's funnel plot, the scatter point distribution was basically symmetric, indicating that there was no publication bias in the included study. Conclusion: CRS+HIPEC can improve the OS of patients with colorectal cancer peritoneal metastasis.

[Progress in diagnosis and treatment of rectal neuroendocrine neoplasms]

Neuroendocrine neoplasms (NENs) are relatively rare heterogeneous tumors that originate from peptidergic neurons and neuroendocrine cells and have been referred to as "carcinoids" in the past. Although this type of tumor had been previously considered to be indolent tumor with a low degree of malignancy, with the development of medicine and clinical study, researchers found that NENs had the potential to metastasize. They can occur in any part of the body where neuroendocrine cells are distributed and gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) are the most common type of NENs.Due to the improvement of techniques such as endoscopy and imaging, the incidence of rectal neuroendocrine tumors(R-NENs) and the number of related clinical researches have both increased significantly in recent years. Although researches in Chinese and foreign medical centers are mostly retrospective studies of small samples and the efficacies of different treatment methods are still under debating and lack of sufficient medical evidence to support, the diagnosis and treatment of this disease is gradually becoming standardized according to the proposal of corresponding guidelines. The recent advances in the epidemiology, diagnosis and treatment of rectal neuroendocrine neoplasms are reviewed in this paper.

miRNA-21 promotes gastric cancer growth by adjusting prostaglandin E2

OBJECTIVE

It is to study the stimulation and possible active mechanism of miRNA-21 on AGS proliferation of gastric cancer.

MATERIALS AND METHODS

AGS gastric cancer cells were cultivated in vitro and then divided into the blank control group, the PGE2 (prostaglandin E2) group, the anti-miRNA-21 group and the PGE2 + anti-miRNA-21 group and the MTT and the flow cytometry methods were adopted to test the effect of PGE2 or/and anti-miRNA-21 intervention on AGS cell proliferation and apoptosis and the differences to miRNA-21 expression. In addition, the cells were also divided into the blank control group, the PGE2 group, the PGE2 + Perifosine group, the PGE2 + anti-miRNA-21 group and the PGE2 + anti-miRNA-21 + Perifosine group and the MTT and flow cytometry methods were adopted to test the effect of Perifosine intervention on AGS cell proliferation and apoptosis and on PTEN and p-AktmRNA and protein expressions.

RESULTS

Compared with the control group, AGS cell proliferation activity increased significantly, the apoptosis rate decreased and the miRNA-21tmRNA and protein expression increased in the PGE2 group (p < 0.05); compared with the PGE2 group, the AGS cell proliferation rate decreased, the apoptosis rate increased and the miRNA-21mRNA and protein expressions decreased (p < 0.05) in the anti-miRNA-21 group and the PGE2 + anti-miRNA-21 group. In addition, after intervention of Perifosine, the AGS cell proliferation rate decreased, the apoptosis rate increased, the PTEN mRNA and protein expressions increased and the pAktmRNA and protein expressions decreased (p < 0.05).

CONCLUSIONS

miRNA-21 may promote the growth of gastric cancer cells by adjusting and controlling PTEN/Akt signal passage mediated PEG2.

[Evaluation of efficacy of immunosuppressive therapy plus recombinant human thrombopoietin for children with severe aplastic anemia]

Objective: To evaluate the therapeutic efficacy and safety of immunosuppressive therapy (IST) combined with recombinant human thrombopoietin (rhTPO) for severe aplastic anemia (SAA) in pediatric patients. Method: A retrospective case-control study was conducted and the clinical data of 45 pediatric patients with de novo SAA admitted to the Anemia Diagnosis and Treatment Center of Chinese Academy of Medical Sciences & Blood Disease Hospital during the period from December 2009 to December 2014 were analyzed. Among them, 15 patients were treated with the regimen of IST together with rhTPO and 30 patients were given IST treatment only. The variation characteristics of the peripheral blood routine as well as the transfusion of blood products was dynamically observed, and the therapeutic efficacy was assessed respectively after 3, 6 and 12 months after the treatment. In the meantime, adverse effects related to rhTPO application were recorded. Thereafter, the statistics of the two groups were compared by non-parametric rank sum test. Result: Among 45 pediatric patients, there were 26 male and 19 female, and the median age was 11 years (6-14). The number of patients received good hematological response(complete remission (CR) plus good partial response (GPR)) in the combinatory group versus vs. the IST group was 6 vs. 3 patients (χ(2)=3.906, P=0.048) at the 3rd month, 7 vs. 7 patients (χ(2)=1.568, P=0.210) at the 6th month, and 13 vs. 14 patients (χ(2)=6.667, P=0.01) at the 12th month respectively. For those achieved good hematological response at the 3rd month, the amount of platelets transfusion and red blood cells transfusion of the combined group were both less than that of the IST group during the period from the 10th to the 12th weeks (platelets transfusion: 1.4 U vs. 2.9 U, t=-3.523, P=0.002; red blood cells transfusion: 0.8 U vs. 2.6 U, t=-2.392, P=0.026). No serious adverse effect related to rhTPO application was observed in the IST combined with rhTPO group. Conclusion: Application of rhTPO can improve the short-term therapeutic efficacy of IST for pediatric SAA, alleviate transfusion dependence, and has a good safety profile.

[The characteristic of hereditary spherocytosis related gene mutation in 37 Chinese hereditary spherocytisis patients]

目的

揭示遗传性球形细胞增多症（HS）红细胞膜蛋白基因突变特征。

方法

应用二代测序技术检测2015年4月至2018年1月临床明确诊断的51例HS患者红细胞膜蛋白基因突变情况，将检出并预测为红细胞膜蛋白基因有害突变的37例患者纳入研究，分析基因突变构成、突变类型及与临床表现型的关系。

结果

37例HS患者中，ANK1突变17例（45.9%）、SPTB突变14例（37.8%）、SLC4A1突变5例（13.5%）、ANK1突变复合SPTB突变1例（2.7%），未发现SPTA1及EPB42突变。红细胞膜蛋白基因突变类型中无义突变（36.8%）和错义突变（31.6%）最常见。在检出的38个突变位点中，34个为新发突变（89.5%）。16例HS患者进行父母基因验证，6例（37.5%）为遗传获得突变，10例（62.5%）为自发突变。HS患者外周血细胞参数与红细胞膜蛋白突变基因类型无关；轻型+中间型患者SPTB突变构成比更高，重型患者ANK1突变构成比更高，但差异无统计学意义（P=0.664）。

结论

中国HS以ANK1和SPTB基因突变最常见，突变类型主要为错义突变和无义突变；不同HS相关基因突变与HS严重程度间无明显相关。

[Using target next-generation sequencing assay in diagnosing of 46 patients with suspected congenital anemias]

目的

评估靶向二代基因测序（NGS）在先天性贫血诊断中的价值。

方法

设计含217个先天性贫血相关致病基因的NGS基因组合——BDHAP-2014，对2014年8月至2017年7月连续就诊的临床怀疑诊断先天性贫血的患者进行NGS检测和亲代验证。

结果

共纳入46例患者，临床疑诊分别为范可尼贫血（FA）11例、先天性红细胞生成异常性贫血（CDA）8例、先天性铁粒幼红细胞性贫血（CSA）6例、先天性溶血性贫血（CHA）12例、先天性角化不良（DC）1例、铁剂难治性缺铁性贫血（IR-IDA）4例及未明原因的血细胞减少（Uc）4例。经靶向NGS检测，28例（60.9%）患者明确了诊断和（或）分型，累及12个基因共44种致病性突变。其中26例（56.5%）基因诊断结果与临床疑诊相符，包括FA（5/11，45.5%）、CSA（6/6，100.0%）、CDA（3/8, 37.5%）及CHA（12/12，100.0%）；2例（4.3%）患者的基因诊断结果与临床疑诊不一致，依据NGS纠正了诊断，包括1例DC和1例家族性噬血细胞性淋巴组织细胞增生症（FHL）；12例CHA依据基因检查结果进一步明确了溶血类型。18例（39.1%）患者未明确致病基因，最终未能明确诊断。

结论

NGS对临床疑诊先天性贫血患者具有重要的诊断价值，可为临床治疗选择提供依据。

[Clinicopathological characteristics of adult T cell leukemia/lymphoma]

Objective: To investigate the clinical presentation, clinicopathologic features, diagnosis and differential diagnosis of adult T cell leukemia/lymphoma (ATLL). Methods: Four cases of ATLL from Fujian Cancer Hospital between October 2017 and May 2018 were analyzed using hematoxylin-eosin and immunohistochemical stains and polymerase chain reaction (PCR) for HTLV-1 provirus genes. The relevant literature was reviewed. Results: There were two males and two females, age range 38-80 years. All patients were from coastal cities of Fujian province. Clinical presentations including lymphadenopathy, hepatomegaly and splenomegaly were detected in most patients; skin lesion, hypercalcemia and lymphocytosis were also commonly detected.Histologically, there was diffuse effacement of the normal architecture by tumor cells infiltration. The inflammatory background is usually sparse, with scanty eosinophils. The atypical lymphoid cells were typically medium to large sized with pronounced nuclear pleomorphism, irregular nuclei, chromatin clumping and prominent nucleoli. Blast-like cells with transformed nuclei were present in variable proportions. Giant cells with convoluted or cerebriform nuclear contours may be present. Rare cases may be composed predominantly of anaplastic tumor cells. Characteristic "flower cells" with large multi-lobated nuclei can be seen. The tumor cells were strongly positive for CD2, CD3, CD5, CD4 and CD25, but negative for CD7, CD8 and cytotoxic molecules (including TIA-1, Granzyme B and perforin). In three cases, the large transformed cells were positive for CD30. In one case, the anaplastic large cells were diffusely and strongly positive for CD30. All cases were negative for EBER, but positive for HTLV-1 provirus. Conclusions: ATLL is a rare type of T cell lymphoma with unique clinical and pathological features, and should be distinguished from peripheral T cell lymphoma, NOS, ALK negative anaplastic large cell lymphoma and mycosis fungoides. Hypercalcemia, systemic disease, characteristic "flower cells" and specific immunophenotypic profile of CD3(+), CD4(+), CD25(+), and CD7(-) are highly suggestive. However, ATLL can only be confirmed if the presence of HTLV-1 provirus.

[Delayed hematologic response to immunosuppressive therapy in severe aplastic anemia]

目的

分析极重型／重型再生障碍性贫血（V/SAA）患者一线免疫抑制治疗（IST）迟发血液学反应特征，探讨难治性V/SAA尽早二次治疗的合理性。

方法

回顾性分析一线接受IST的533例V/SAA患者临床资料，定义IST后6个月内获得血液学反应为应时反应，定义6~12个月获得血液学反应为迟发反应，观察迟发反应的发生率、血液学反应质量及其影响因素。

结果

533例患者中，45例（8.44%）获得迟发反应，占未获得应时反应且继续接受环孢素A治疗患者的29.03%（45/155）。至IST后12个月及随访结束时迟发反应组血液学反应质量均劣于应时反应组（χ²=62.616，P<0.001和χ²= 6.299，P=0.043）。迟发反应组VSAA患者比例高于应时反应组（57.8％对38.3%，P=0.013），外周血网织红细胞（ARC）比例、ARC计数以及ANC更低，多因素分析显示治疗前ARC<10×10⁹/L的患者获得应时反应的机会明显减少[OR=3.641(95% CI 1.1718~7.719），P=0.001]；未发现独立预测IST后6个月无效患者获得迟发血液学反应的因素。6个月未获血液学反应患者5年总生存率为76.50%（95% CI 71.6%~81.4%）、无事件生存率为29.10%（95% CI 25.2%~33.0%），均显著低于应时反应组患者的97.6%（95% CI 96.6%~98.6%）、84.0%（95% CI 81.1%~86.9%）（P值均<0.001）。

结论

V/SAA患者IST获得迟发血液学反应难以预测，比例较小，疗效质量相对较差。难治性V/SAA患者尽早进行挽救治疗是合理的。

[Treatment of transfusion-dependent nonsevere aplastic anemia with cyclosporine A plus ATG/ALG versus cyclosporine A plus androgens: a retrospective single center study]

目的

比较抗人胸腺／淋巴细胞球蛋白（ATG/ALG）联合环孢素A (CsA）与CsA联合雄激素一线治疗输血依赖非重型再生障碍性贫血（TD-NSAA）疗效。

方法

回顾性分析2007年8月至2014年9月125例TD-NSAA患者临床资料，比较一线采用ATG/ALG联合CsA与CsA联合雄激素治疗的血液学反应及生存情况。

结果

125例TD-NSAA患者中，男70例，女55例，男女比为1.27∶1；中位年龄27 (6~66）岁。其中48例一线接受ATG/ALG联合CsA治疗，77例一线接受CsA联合雄激素治疗，两组早期死亡率分别为2.1%（1/48）及0 (0/77）（P=0.384）。ATG/ALG联合CsA组患者治疗后3个月总体血液学反应率（70.8％对45.5%，P=0.006）和良好血液学反应率（27.1％对10.4%，P=0.015）均高于CsA联合雄激素组；两组治疗后6个月总体血液学反应率（75.0％对55.8%，P＝0.031）与良好血液学反应率（41.7％对22.1%，P=0.020）差异亦有统计学意义，治疗后6个月ATG/ALG联合CsA组脱离血制品输注依赖的中位时间为36.5 (0~149) d，明显短于CsA联合雄激素组的98 (14~180）d（P<0.001）。ATG/ALG联合CsA组与CsA联合雄激素组患者3年总生存率（97.9％对100.0%，P=0.227）和无事件生存率（71.2％对59.5%，P=0.227）差异无统计学意义。

结论

一线采用CsA联合雄激素治疗TD-NSAA血液学反应率和血液学反应质量均不及ATG/ALG联合CsA，两组患者短期生存率相同，应优选ATG/ALG联合CsA方案治疗TD-NSAA。

[The clinical and laboratory characteristics of congenital pyruvate kinase deficiency]

Clinical data of 19 patients with congenital pyruvate kinase deficiency were analyzed. Insufficient pyruvate kinase confirmed the diagnosis. Laboratory parameters of hemolysis were summarized. In cases of neonatal hyperbilirubinemia and unexplained hemolytic anemia, pyruvate kinase activity and next generation sequencing test may help the early diagnosis.

[Analysis of infection and drug-resistance in 6 107 cases of extrapulmonary tuberculosis in Chengdu area]

Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years.The epidemiological data, infection and drug resistance were analyzed statistically. Results: There were 21 036 cases of mycobacterial culture from January 2013 to December 2015, of which 7 119 were positive(33.8%). Extrapulmonary tuberculosis was found in 6 107 cases, of which 896 were positive, accounting for 12.6% of the positive cases(896/7 119). Culture-positive cases of extra-pulmonary tuberculosis showed a rising trend from 2013 to 2015 (n=174, 310, 421, respectively), and the annual average increasing rate was over 50%.Cases were distributed at younger ages (21-40 years), with an average age of 34 years.There were more male patients, with a male to female ratio of 2.1∶1. The most common site of extrapulmonary tuberculosis was the bone(62/243, 25.5%), followed by lymph node(283/1 297, 21.8%), pleural(289/1 840, 15.7%), urinary tract(63/452, 13.9%), peritoneum(41/303, 13.5%), meningeal(156/1 915, 8.1%)and other types of tuberculosis(2/57, 3.5%). Drug sensitivity test of 896 extrapulmonary tuberculosis strains showed that the resistance rate (from high to low) was in the order of isoniazid, rifampicin, streptomycin, ofloxacin, ciprofloxacin, amikacin, capreomycin and ethambutol. Multidrug-resistant(MDR)and extremely-drug resistant (XDR) rate was 9.7 %(87/896)and 2.0%(17/896)respectively. Conclusions: Cases of extrapulmonary tuberculosis sent for bacterial culture and the positive rate showed a rising trend by years in Chengdu area.The drug resistance level was higher than that reported both in China and abroad.The prevention and treatment of extrapulmonary tuberculosis should be strengthened in this area.

Narcissus yellow stripe virus and Narcissus mosaic virus detection in Narcissus via multiplex TaqMan-based reverse transcription-PCR assay

AIMS

Development of a multiplex TaqMan RT-qPCR assay to simultaneously detect Narcissus yellow stripe virus (NYSV) and Narcissus mosaic virus (NMV), frequently causing mixed narcissus infection. Feasibility verification was confirmed in natural samples.

METHODS AND RESULTS

Primers and probes were designed based on the conserved CP gene regions of NYSV or NMV and their suitability for singleplex and multiplex TaqMan RT-qPCR assays as well as for conventional RT-PCR. Conventional RT-PCR, singleplex and multiplex TaqMan RT-qPCR assays proved to be NYSV and NMV specific. P-values and coefficients of variation of TaqMan RT-qPCR assays indicated high reproducibility. Significantly increased sensitivity was achieved compared to conventional RT-PCR. The detection limit of both viruses was 10³ copies with superior correlation coefficients and linear standard curve responses between plasmid concentrations and Ct values. NYSV and NMV infection of narcissus leaves, petals and bulbs could successfully be detected via our multiplex RT-qPCR method at 1·25 mg.

CONCLUSION

Our multiplex TaqMan RT-qPCR assay provides rapid, specific, sensitive and reliable testing to simultaneously detect NYSV and NMV, supplying useful routine monitoring for different narcissus samples.

SIGNIFICANCE AND IMPACT OF THE STUDY

Efficient identification and discrimination of the narcissus viruses provides reliable information for scientists and conventional growers. Furthermore, it enriches the information of NYSV, NMV and other narcissus viruses.

[Correlation of the degree of band 3 protein absence on erythrocyte membrane by eosin-5'-maleimide binding test and clinical phenotype in hereditary spherocytosis]

目的

探讨伊红-5′-马来酰亚胺标记的流式细胞术（EMA结合试验）检测红细胞膜骨架带3蛋白缺失程度与遗传性球形红细胞增多症（hereditary spherocytosis，HS）临床表现型的关系。

方法

分析258例未行脾切除术治疗的HS患者临床和实验室特征，评估EMA结合试验结果与贫血程度、溶血和造血代偿参数的关系。

结果

258例HS患者中，男128例，女130例，中位年龄23（2~70）岁。代偿性溶血91例、轻度贫血53例、中度贫血78例、重度贫血36例。EMA结合试验荧光强度减低中位数为29.97%（16.09%~47.34%），平均数为（29.70±6.28）%。荧光强度减低程度与红细胞平均体积呈负相关（r=−0.343，P<0.001），与红细胞平均血红蛋白浓度呈正相关（r=0.223，P<0.001），与网织红细胞比例（r=−0.015，P=0.813）和绝对值（r=0.080，P=0.198）均无明显相关性，与血清间接胆红素水平无明显相关（r=−0.009，P=0.902），与HGB水平无明显相关性（r=−0.067，P=0.280）。按EMA标记缺失程度四分位区间分组，不同EMA标记缺失组与HS贫血严重程度分组亦无明显相关性（C=0.150，P=0.746）。

结论

EMA结合试验结果与HS贫血程度无关。

Long non-coding RNA CCAT2 promotes the breast cancer growth and metastasis by regulating TGF-β signaling pathway

OBJECTIVE

Long non-coding RNA (LncRNA) CCAT2 plays an important role in tumorigenesis, tumor growth and metastasis. In this study, we reported that long noncoding RNA CCAT2 (LncRNA CCAT2) could regulate TGF-β signaling pathway in breast cancer.

PATIENTS AND METHODS

The relative mRNA expression level of CCAT2 in adjacent non-cancerous and breast cancer tissues without or with metastasis were analyzed by quantitative Real-time polymerase chain reaction (qRT-PCR). The mRNA expression levels of CCAT2 in breast cancer cell lines were analyzed by qRT-PCR. Proliferation, invasion and migration of breast cancer cells were detected after infected with si-NC or si-CCAT2. Flow cytometry analysis was used to detect the cell cycle distribution and apoptosis rate in breast cancer cells after infected with si-NC or si-CCAT2. The relative protein expression level of TGF-β, Smad2 and α-SMA in breast cancer cells after infected with si-NC or si-CCAT2 were analyzed by Western blot.

RESULTS

The relative mRNA expression level of CCAT2 in breast cancer tissues was significantly increased compared with adjacent non-cancerous tissues. The expression level of CCAT2 in breast cancer without metastasis was decreased compared with breast cancer metastasis. Meanwhile, down-regulation of CCAT2 inhibited the proliferation, invasion and migration in breast cancer cells. Furthermore, down-regulation of CCAT2 caused breast cancer cells cycle arrested in G0/G1 phase and promoted cell apoptosis. Down-regulation of CCAT2 significantly down-regulated the protein expression levels of TGF-β, Smad2 and α-SMA in breast cancer cells.

CONCLUSIONS

CCAT2 was highly expressed in breast cancer. Down-regulation of CCAT2 inhibited the proliferation, invasion and migration and promoted cell apoptosis in breast cancer cells by regulating TGF-β signaling pathway.

[Comparison of efficacy and safety of two different dose of recombinant human thrombopoietin regimens in severe aplastic anemia patients with immunosuppressive therapy]

目的

比较不同重组人TPO（rhTPO）方案联合免疫抑制剂治疗重型再生障碍性贫血（SAA）的近期疗效。

方法

回顾性分析接受一线免疫抑制治疗（IST）的61例成人SAA初诊患者资料，对比分析18例IST联合rhTPO每日1次（连续组）与43例IST联合rhTPO隔日1次（间日组）患者的疗效差异。

结果

两组患者在IST前基础临床特征差异无统计学意义。IST后3个月和6个月进行疗效评估，连续组与间日组患者总体血液学反应率比较差异无统计学意义（3个月：50.0%对51.2%，P= 0.934；6个月：77.8%对69.8%，P=0.525）。连续组IST后3个月良好血液学反应率明显高于间日组（38.9%对9.3%，P=0.011）。rhTPO应用后4周和8周两组脱离红细胞输注率差异无统计学意义（4周：22.2%对18.6%，P=0.736; 8周：55.6%对46.5%，P=0.519），而治疗后8周脱离血小板输注率连续组明显高于间日组（88.9%对48.8%，P=0.003）。每日连续应用rhTPO治疗并不增加不良反应事件的发生。

结论

每日1次较隔日1次应用rhTPO促进SAA造血恢复和减少血小板输注依赖更为有效。

[Analysis of the compliance of chronic rhinosinusitis surgical treatment for adults]

Objective:To investigate the factors which effect the compliance of treatment for chronic rhinosinusitis(CRS) patients. Method:Offering disease education to 386 patients who suffered from CRS, then find out the reason why some of them refuse to accept surgery through a half-year follow-up by phone and analysis the clinical information. Result:One hundred and ninety-seven accepted surgery while.Not among 386 patients the compliance rate was 51.04%，we found out that the factors affecting compliance were educational level and VAS scale using χ² test and logistic regression. Conclusion:Patients with higher educational level, lower VAS score,turned to be less compliable; and we should still work on how to improve the patients' compliance.

[Clinical characteristics and prognosis in 12 patients with adult T cell leukemia/lymphoma confirmed by HTLV-1 provirus gene detection]

Objective: To analyze the clinical characteristics and prognosis of adult T cell leukemia/lymphoma (ATLL). Methods: Peripheral blood samples from patients who were suspected as ATLL from March, 2013 to July, 2015, were collected for HTLV-1 provirus genes detection in genomic DNA extraction by PCR. Cases showing positive results were confirmed as ATLL. Clinical and laboratory characteristics, therapeutic outcomes and survival evaluation were collected. Results: 12 out of 23 suspected patients were confirmedly diagnosed as ATLL through HTLV-1 provirus genes detection by PCR. Eight patients were male and four patients were female. Median age was 51 (range 28-66) years old. All of those patients came from coastal cities of Fujian province where a HTLV-1 epidemic area locates. In the subtype classification of these 12 ATLL, 11 patients were classified as acute type and one case as lymphoma type ATLL. As one of the clinical characteristics of ATLL, ' flower cells ', with typical or atypical morphology had been observed in a high rate (81.8%). Clinical symptom such as hepatomegaly, splenomegaly and lymphadenectasis were detected in most of patients, and hypercalcemia and elevated LDH were also noted commonly. The ATLL cells immunophenotype were typical, and the major subtype was CD4+ CD8- type. Confection of hepatitis B virus was detected in a high rate (54.5%). Ten patients received chemotherapy, and 2 cases in complete remission after chemotherapy received allogeneic hematopoietic stem cell transplantation. At the end of the follow-up, 7 cases died, 4 cases survived, 1 case was lost, and the median survival was 2.8 (0.9-10.8) months. We found a case had HTLV-1 provirus negative after transplantation. Conclusion: In the coastal area of Fujian Province, ATLL is not rare. Characteristics of those ATLL are typical. But prognosis is still unsatisfactory.

Expression profile analysis of ascorbic acid-related genes in response to temperature stress in the tea plant, Camellia sinensis (L.) O. Kuntze

Ascorbic acid (AsA), also known as ascorbate or vitamin C, is a natural organic compound in green plants that has antioxidant properties, and is an essential nutrient for humans. The tea plant, Camellia sinensis (L.) O. Kuntze, is an important global economic crop. Here, the expression profiles of genes related to AsA biosynthesis and recycling were analyzed in tea plants in response to temperature stress. Eighteen genes involved in AsA biosynthesis and recycling pathways were identified based on the transcriptome database. The expression levels of CsPGI1 in two varieties of tea plants ('Yingshuang' and 'Huangjinya') increased, peaked at 4 h, and then decreased in response to cold stress. In 'Yingshuang', the genes involved in AsA biosynthesis pathway rapidly responded to heat stress and substantially increased their expression levels at 1 h. The expression levels of CsMDHAR, CsDHAR1, and CsDHAR2 increased sharply at 1 h in response to heat stress in 'Yingshuang'. In contrast, the expression levels of CsMDHAR, CsDHAR1, and CsDHAR2 in 'Huangjinya' gradually increased during heat treatment from 1 to 24 h. The expression trends of two DHAR isoforms differed in 'Huangjinya' during cold stress. The expression patterns of AsA-related genes differed in the different tea plant varieties and depended on temperature. The genes involved in AsA biosynthesis and recycling pathways were induced by heat and cold stress. Our study provides useful data with which to improve the resistance of tea plants to cold and heat stress.

Risk of hip fracture following stroke, a meta-analysis of 13 cohort studies

This study systematically reviews prospective and retrospective cohort studies evaluating the risk of hip fracture following stroke. Stroke survivors are at high risk of hip fracture and had a 1.5-fold increased risk compared to stroke-free men and women of the same age. Hip fracture often occurs in ageing and female stroke patients. We performed a meta-analysis to summarize evidence from prospective and retrospective cohort studies about the risk of hip fracture following stroke. We identified English and non-English publications in MEDLINE and EMBASE using stroke and fracture as keywords to 31 December 2015. The data of the incidence of hip fracture were extracted to calculate raw incident rate in stroke survivors as well as risk of hip fractures in strokes comparing populations using a random-effects model. Subgroup analyses were performed to identify the potential influence of some factors. Six prospective and seven retrospective cohort studies were included, involving 512,214 stroke patients with 22,559 hip fractures. The pooled prevalence of hip fractures was 4.87 % (95 % CI, 4.05 to 5.68 %) in stoke patients. We conducted subgroup analysis according to sex, age, duration of follow-up, study design, and region, which showed that female (vs. male) stroke patients older than 70 years (vs. those less than 70 years) and duration of follow-up more than 2 years (vs. those less than 2 years) have higher proportions of hip fractures. Four studies showed that stroke patients had a significantly higher risk of hip fracture compared with the general population, while the other study had a non-significant higher risk. The overall prevalence of hip fracture was 3.28 % (3431 of 104,646) in stroke patients and 2.83 % (36,493 of 1,287,726) in general population, respectively, and the unadjusted combined relative risk of hip fracture was 1.54 (95 % CI, 1.06-2.25). Hip fractures often occur in ageing and female stroke patients.

[Application of three risk assessment models in occupational health risk assessment of dimethylformamide]

Objective: To investigate the application of United States Environmental Protection Agency (EPA) inhalation risk assessment model, Singapore semi-quantitative risk assessment model, and occupational hazards risk assessment index method in occupational health risk in enterprises using dimethylformamide (DMF) in a certain area in Jiangsu, China, and to put forward related risk control measures. Methods: The industries involving DMF exposure in Jiangsu province were chosen as the evaluation objects in 2013 and three risk assessment models were used in the evaluation. EPA inhalation risk assessment model: HQ=EC/RfC; Singapore semi-quantitative risk assessment model: Risk= (HR×ER) ^1/2; Occupational hazards risk assessment index=2^{Health effect level}×2^{exposure ratio}×Operation condition level. Results: The results of hazard quotient (HQ>1) from EPA inhalation risk assessment model suggested that all the workshops (dry method, wet method and printing) and work positions (pasting, burdening, unreeling, rolling, assisting) were high risk. The results of Singapore semi-quantitative risk assessment model indicated that the workshop risk level of dry method, wet method and printing were 3.5 (high) , 3.5 (high) and 2.8 (general) , and position risk level of pasting, burdening, unreeling, rolling, assisting were 4 (high) , 4 (high) , 2.8 (general) , 2.8 (general) and 2.8 (general) . The results of occupational hazards risk assessment index method demonstrated that the position risk index of pasting, burdening, unreeling, rolling, assisting were 42 (high) , 33 (high) , 23 (middle) , 21 (middle) and 22 (middle) . The results of Singapore semi-quantitative risk assessment model and occupational hazards risk assessment index method were similar, while EPA inhalation risk assessment model indicated all the workshops and positions were high risk. Conclusion: The occupational hazards risk assessment index method fully considers health effects, exposure, and operating conditions and can comprehensively and accurately evaluate occupational health risk caused by DMF.

[The expression of MiR-148a in nasopharyngeal carcinoma and its effect on tumor cell biology functions in nasopharyngeal carcinoma]

Objective:Nasopharyngeal carcinoma(NPC) is a common malignant tumor, in recent years,most of studies have found that micro RNA played an important role in the development of NPC.This study was to explore the expression level of MiR-148a and its effect on the biological functions of NPC cells.Method:The expression of MiR-148a in NPC cell line CNE2 was detected by Real-time PCR method.MTT,clone formation assay and flow cytometry were applied to detect cell proliferation and apoptosis. We predicted that EGFR was the downstream target genes of MiR-148a through the analysis of bioinformatics software. Then the expression change of EGFR was measured by Real-time PCR and Western blot.Result:Comparing with normal nasopharyngeal epithelial tissue cells,MiR-148a expression level was significantly reduced in NPC cell line CNE2.MTT,clone formation assay and flow cytometry test show that overexpression of MiR-148a can inhibit cell proliferation and promote cell apoptosis.Real-time PCR and Western blot test show that MiR 148a can reduce the expression of EGFR.Conclusion:MiR-148a can affect the proliferation and apoptosis of NPC cell,and it is likely to be involved in the development and progression of NPC.

[The clinical application of balloon dilation Eustachian tuboplasty in patients with Eustachian tube dysfunction]

Objective:To evaluate the clinical application of balloon dilation Eustachian tuboplasty (BET) in patients with Eustachian tube dysfunction (ETD). Method:Twenty-five patients who were diagnosed as ETD and reserved BET surgery were retrospectively analyzed in this study. Result:After 1-year's follow-up, among 25 ETD patients, the total cure rate was 55.9% and the effective rate was 85.3%. The cure rate and effective rate was 52.9% and 76.5% in the delayed opening of the ET group; 58.8% and 94.1% in the unopened group, which was higher than the other one. Conclusion:BET surgery is safe and effective in the treatment of BET patients.

Proanthocyanidins affects the neurotoxicity of Aβ25-35 on C57/bl6 mice

OBJECTIVE

To investigate the influence of procyanidins on the impairment of memory.

MATERIALS AND METHODS

Thirty male C57bl/6 mice were divided into five groups: low, middle, and high concentration, model, and control groups. Intracerebroventricular injection of β-amyloid25-35 in C57bl/6 mice caused an impairment of learning and memory. Next day, intragastric administration of procyanidins in the treatment group mice: (lower, middle and high concentration). Hoechst staining observed apoptosis of neuronal nuclei in the hippocampus. Immunohistochemistry determined synaptic remodeling reaction and the expression level of glial inflammatory response.

RESULTS

Compared with the model group, the proportion of neuronal apoptosis decreased in the hippocampal CA1 region of the treatment group. The Synaptic (SYN) density was increased, and the level of activated astrocytes and microglia expression in the hippocampus was decreased.

CONCLUSIONS

Procyanidins have a protective influence on Aβ25-35 mice hippocampus neuron, reducing nerve cell damage and eases learning and memory deficit.

The association between the -2518A/G polymorphism in the MCP-1 gene and the risk of pulmonary tuberculosis in Sichuan Chinese population

OBJECTIVE

The -2518A/G polymorphism in the Monocyte chemotactic protein-1 (MCP-1) gene may play an important role in regulating immunological reactions and may be associated with pulmonary tuberculosis (PTB). However, the relationship for the populations in Sichuan province of China remains unknown. The objective of the current study was to analysis that association.

PATIENTS AND METHODS

A total of 386 PTB patients and 398 controls were recruited. The genotypes were identified using PCR-RFLP and sequencing method. Data was analyzed using SPSS 11.0 software.

RESULTS

Significant association was found between the polymorphism and the risk of PTB: AG vs. AA: OR = 1.37, 95% CI = 0.98-1.92 and p = 0.06; GG vs. AA: OR = 1.69, 95% CI = 1.14-2.50 and p = 0.009; AG+GG vs. AA: OR = 1.47, 95% CI = 1.07-2.01 and p = 0.02; G vs. A: OR = 1.31, 95% CI = 1.08-1.60 and p = 0.007.

CONCLUSIONS

The current study suggested that the 2518A/G polymorphism in the MCP-1 gene was associated with risk of PTB in population of Sichuan province in China.

C-reactive protein and risk of fracture: a systematic review and dose-response meta-analysis of prospective cohort studies

This study systematically reviews prospective cohort studies evaluating the relationship between C-reactive protein (CRP) concentrations and subsequent fracture risk. The positive association cannot completely explain the existing evidence, and further studies are needed to demonstrate the shape of the association.

INTRODUCTION

We aimed to perform a systematic review and dose-response meta-analysis of published prospective studies evaluating associations of high-sensitivity CRP (hs-CRP) levels with fracture risk in general populations.

METHODS

We identified relevant studies by searching MEDLINE and EMBASE databases from their inception to May 20, 2014. We included published prospective studies evaluating the associations of hs-CRP levels with risk of fracture in general populations. Two reviewers working independently abstracted the data.

RESULTS

Eight prospective cohort studies involving 34,840 participants and 3,407 incident fracture events were eligible for the present analyses. A meta-analysis of six prospective studies showed that the overall risk for incident fracture in a comparison of individuals in the top tertile with those in the bottom tertile of baseline hs-CRP levels was 2.14 [95% confidence interval (CI) 1.51-3.05, I(2) = 62.3%]. The moderate heterogeneous disappeared when one study was excluded. However, the remaining two studies reported inconsistent results. One study with the biggest sample size showed a U-shaped association for CRP and fracture risk (the association was positive when CRP > 1 mg/L). Similarly, another study reported that per doubling of CRP was positive only when CRP > 3 mg/L.

CONCLUSION

In summary, the present analysis showed that the relationship between CRP concentrations and subsequent fracture risk is still inconsistent. The positive association cannot completely explain the existing evidence, and further larger prospective cohorts with more power are needed to demonstrate the shape of the association, especially for the relatively low CRP concentrations, such as less than 3 mg/L.

First Report of Coleus blumei viroid 5 from Coleus blumei in India and Indonesia

Coleus blumei, which was found originally in Indonesia, is an ornamental plant grown worldwide. It can be infected by several viroids of the genus Coleviroid, family Pospiviroidae. Six main viroids that infect coleus have been reported: Coleus blumei viroid 1 through 6 (CbVd-1 ~ CbVd-6). Although CbVd-1 was first reported in a commercial coleus in Brazil in 1989 (1), and then in Germany, Japan, Canada, Korea, China, and India, CbVd-5 was reported only in China in 2009 (2). Symptoms caused by CbVd-5 varied depending on different cultivars, and in case of an unknown cultivar of "Red with dark green edge," are very clear albino symptoms. From 2010 to 2011, 60 and 3 leaf samples of coleus were collected from Hyderabad, India, and Java, Indonesia, respectively, and subjected to low molecular weight RNA extraction according to Li et al. (3). The results of dot-blot hybridization using CbVd-5 cRNA probes and RT-PCR using CbVd-5 specific primers (CbVd-5-P_F: 5'-TGACTAGAACAGTAGTAAAG-3' / CbVd-5-P_R: 5'-AATTGAGGTCAAACCTCTTT-3') demonstrated that 28 out of the 60 samples from India and all three samples from Indonesia were positive for CbVd-5. The resulting RT-PCR fragments from one sample selected randomly from each country were cloned into the pMD18-T vector (Takara) and transformed into E. coli DH5α competent cells. Five positive clones of each sample were sequenced. The result of sequence analysis revealed that the similarities of CbVd-5 between the sequences we obtained and the reference sequence (GenBank Accession No. NC003683) were 97.8 to 100%. Bioassay using nine viroid-free coleus plants from three cultivars (three from each cultivar), inoculated with CbVd-5 infectious clones by stem slashing, demonstrated that CbVd-5 could induce albino symptom on the leaves of the unknown cultivar "Red with dark green edge" 2 months after inoculation. To our knowledge, this is the first report of CbVd-5 from India and Indonesia, and the second report of CbVd-5 in the world. Considering the effect of CbVd-5 on the appearance of coleus and its recombination ability, a certification program may be needed to control the spread of this viroid. References: (1) M. E. N. Fonseca et al. Fitopatol. Bras. 14:94, 1989. (2) W. Y. Hou et al. Arch. Virol. 154:315, 2009. (3) S. F. Li et al. Ann. Phytopathol. Soc. Jpn. 61:381, 1995.

First Report of Kudzu mosaic virus on Pueraria montana (Kudzu) in China

Kudzu (Pueraria montana), a weed widely distributed in southern China, is common in the Fuzhou region of Fujian Province, where many plants show yellow vein mosaic disease. In September 2008, four leaf samples from different plants exhibiting yellow vein mosaic symptom were collected in suburban district of Fuzhou (25°15' N, 118°08' E). Whitefly (Bemisia tabaci) infestation was also observed in this region. Total DNA was extracted from all samples using a CTAB method (4). Universal primers (PA/PB) were used to amplify part of the intergenic region and coat protein gene of DNA-A of begomoviruses (1). An amplicon of approximately 500 bp was obtained from all four samples and then sequenced. Comparison of 500-bp fragments (GenBank Accession Nos. FJ539016-18 and FJ539014) revealed the presence of the same virus (98.8 to 99.4%). A pair of back-to-back primers (Yg3FL-F: 5'-GGATCCTTTGTTGAACGCCTTTCC-3'/Yg3FL-R: 5'-GGATCCCACATGTTTAAAGTAAAGC-3') were designed to amplify the full-length DNA-A from the Chinese isolate identified as Yg3. Sequence analysis showed that full-length DNA-A of Yg3 isolate comprised 2,729 nucleotides (GenBank Accession No. FJ539014) and shared the highest nucleotide sequence identity (91.9%) with Kudzu mosaic virus (KuMV, GenBank Accession No. DQ641690) from Vietnam. To further test the association of DNA-B fragments with the four samples from southern China, rolling circle amplification (RCA) was performed (3). When RCA products were digested with Sph I, approximately 2.7 kb was obtained from all samples. Yg3 isolate was chosen to be sequenced. Sequence analysis showed that full-length DNA-B of Yg3 isolate comprised 2,677 nucleotides (GenBank Accession No. FJ539015) and shared the highest nucleotide sequence identity (76.8%) with KuMV DNA-B (GenBank Accession No. DQ641691) from Vietnam. Based on the current convention of begomovirus species demarcation of <89% sequence identity cut-off criterion (2), Yg3 was identified as an isolate of KuMV. To our knowledge, this is the first report of association of KuMV with yellow vein mosaic symptom of kudzu in China. References: (1). D. Deng et al. Annals Appl. Biol. 125:327, 1994. (2). C. M. Fauquet et al. Arch. Virol. 148:405, 2003. (3). D. Haible et al. J. Virol. Methods 135:9, 2006. (4). Y. Xie et al. Chinese Sci. Bull. 47:197, 2002.

First Report of the Occurrence of Sweet potato leaf curl virus in Tall Morningglory (Ipomoea purpurea) in China

Natural occurrence of Sweet potato leaf curl virus (SPLCV) has been reported in Ipomoea batatas (sweet potato, Convolvulaceae) or I. indica (Convolvulaceae) in several countries including the United States, Sicily, and China (1-3). In September of 2007, while collecting samples showing begomovirus-like symptoms in the Chinese province of Fujian, we observed tall morningglory (I. purpurea (L.) Roth, also known as Pharbitis purpurea (L.) Voigt), plants with slightly yellow mosaic and crinkled leaves. Total DNA was extracted from leaves of these plants and tested by rolling circle amplification (4). Amplification products were digested by the restriction enzyme BamHI for 30 min. Restriction products (2.8 kb) were then cloned into pMD18T vector (Takara Biotechnology, China) and sequenced. Comparison of complete DNA sequences by Clustal V analysis revealed that these samples were infected by the same virus, and an isolate denoted F-p1 was selected for further sequence analysis. F-p1 was 2,828 nucleotides, with the typical genomic organization of begomoviral DNA-A (GenBank Accession No. FJ515896). F-p1 was compared with the DNA sequences available in the NCBI database using BLAST. The whole DNA sequence showed the highest nucleotide sequence identity (92.1%) with an isolate of SPLCV (GenBank Accession No. FJ176701) from Jiangsu Province of China. The result confirmed that the samples from the symptomatic tall morningglory were infected by SPLCV. To our knowledge, this is the first report of the natural occurrence of SPLCV in I. purpurea, a common weed species in China. References: (1). P. Lotrakul et al. Plant Dis. 82:1253, 1998. (2). R. W. Briddon et al. Plant Pathol. 55:286, 2006. (3) Y. S. Luan et al. Virus Genes 35:379, 2007. (4) D. Haible et al. J. Virol. Methods 135:9, 2006.

Structural stability and magnetic coupling in CaCu(3)Co(4)O(12) from first principles

The structural, electronic and magnetic properties of CaCu(3)Co(4)O(12) were studied by use of the full-potential linearized augmented plane wave method. The calculated results indicate that CaCu(3)Co(4)O(12) is stable both thermodynamically and mechanically. Both GGA (generalized gradient approximation) and GGA+U methods predict that CaCu(3)Co(4)O(12) is metallic. The ferromagnetic configuration is only slightly more stable in energy compared with the non-magnetic configuration (3.7 meV), suggesting that they are competitive for being the ground state. Co is in the low spin state (S = 1/2).

The value of dual time point (18)F-FDG PET imaging for the differentiation between malignant and benign lesions

AIM

To assess the clinical value of dual time point 2-[(18)F]-fluoro-2-deoxy-d-glucose positron emission tomography ((18)F-FDG PET) imaging for the differentiation between malignant and benign lesions.

MATERIALS AND METHODS

Ninety-six patients (28 patients with primary lung cancer, 18 patients with digestive system carcinoma, 13 patients with other malignant tumours, and 37 patients with benign lesions) underwent FDG-PET/CT at two time points: examination 1 at 45-55 min and examination 2 at 160+/-24 (150-180) min after the intravenous injection of 233+/-52 (185-370)MBq (18)F-FDG. Reconstructed images were evaluated qualitatively and quantitatively. The maximum standardized uptake values (SUVmax) of the lesions were calculated for both time points. An increase was considered to have occurred if the SUVs at examination 2 had increased by >10% as compared with those at the examination 1.

RESULTS

The lesions in 24 of 28 (86%) patients with primary lung cancer had an SUVmax > or = 2.5 at examination 1. Of these, SUVmax values increased in 23 patients, but had not changed in one patient, at examination 2. The lesions in the other four patients with primary lung tumour had SUVmax values between 1.5 and 2.5 at examination 1, which were considered as suspected positive, increased SUVmax values were observed in three of these patients at examination 2. The malignant lesions in 17 of 18 patients with digestive system carcinoma showed SUVmax values > or = 2.5 and only one patient had an SUVmax value < 1.5 at examination 1; all lesions showed an increase in SUVmax values at examination 2. In 13 patients with other malignant tumours, all lesions had SUVmax values > or = 2.5 at examination 1 and the SUVmax values were further increased at examination 2. Therefore, the malignant lesions in 54/59 (92%) of patients had SUVmax values > or = 2.5 at examination 1 and showed a further increase in SUVmax value at examination 2. Only 12 of 37 (32%) patients with benign lesions showed SUVmax values > or = 2.5 at examination 1 and nine patients with benign lesions had SUVmax values > or = 2.5 in examination 2. The sensitivity, specificity, accuracy, positive and negative predictive values for the early and delayed imaging were 91.5, 67.6, 82.3, 81.8, and 83.3%, and 98.3, 75.7, 89.6, 86.6, and 96.6%, respectively.

CONCLUSION

The results of the present study provide further evidence that dual time point (18)F-FDG PET imaging is an important noninvasive method for the differentiation of malignant and nonmalignant lesions.

First Report of Ageratum yellow vein virus Causing Tobacco Leaf Curl Disease in Fujian Province, China

A leaf curling disease was observed on 7% of tobacco plants during December 2005 in research plots in the Cangshan District of Fuzhou, Fujian, China. Tobacco plants were infested with Bemisia tabaci, suggesting begomovirus etiology. To identify possible begomoviruses, total DNA was extracted from four symptomatic leaf samples (F1, F2, F3, and F4). The degenerate primers PA and PB were used to amplify part of the intergenic region and AV2 gene of DNA-A-like molecules (3). A 500-bp DNA fragment was amplified by PCR from all four samples. The PCR products were cloned and sequenced (GenBank Accession Nos. EF531601-EF531603 and EF527823). Alignment of the 500-bp sequences for the four isolates indicated that they shared 98.5 to 99.6% nt identity, suggesting that the plants were all infected by the same virus. Overlapping primers TV-Full-F (5'-GGATCCTCTTTTGAACGAGTTTCC-3') and TV-Full-R (5'-GGATCCCACATGTTTAAAATAATAC-3') were then designed to amplify the full-length DNA-A from sample F2. The sequence was 2,754 nucleotides long (GenBank Accession No. EF527823). A comparison with other begomoviruses indicated the F2 DNA-A had the highest nucleotide sequence identity (95.7%) with Ageratum yellow vein virus (AYVV; GenBank Accession No. X74516) from Singapore. To further test whether DNAβ was associated with the four viral isolates, a universal DNAβ primer pair (beta 01 and beta 02) was used (4). An amplicon of approximately 1.3 kb was obtained from all samples. The DNAβ molecule from F2 was then cloned and sequenced. F2 DNAβ was 1,345 nucleotides long (GenBank Accession No. EF527824), sharing the highest nucleotide sequence identity with the DNAβ of Tomato leaf curl virus (97.2%) from Taiwan (GenBank Accession No. AJ542495) and AYVV (88.8%) from Singapore (GenBank Accession No. AJ252072). The disease agent was transmitted to Nicotiana tabacum, N. glutinosa, Ageratum conyzoides, Oxalis corymbosa, and Phyllanthus urinaria plants by whiteflies (B. tabaci) when field infected virus isolate F2 was used as inoculum. In N. tabacum and N. glutinosa plants, yellow vein symptoms were initially observed in young leaves. However, these symptoms disappeared later during infection and vein swelling and downward leaf curling symptoms in N. tabacum and vein swelling and upward leaf curling in N. glutinosa were observed. In A. conyzoides, O. corymbosa, and P. urinaria plants, typical yellow vein symptoms were observed. The presence of the virus and DNAβ in symptomatic plants was verified by PCR with primer pairs TV-Full-F/TV-Full-R and beta 01/beta 02, respectively. The above sequence and whitefly transmission results confirmed that the tobacco samples were infected by AYVV. In China, Tobacco leaf curl Yunnan virus, Tobacco curly shoot virus, and Tomato yellow leaf curl China virus were reported to be associated with tobacco leaf curl disease (1,3). To our knowledge, this is the first report of AYVV infecting tobacco in China. A. conyzoides is a widely distributed weed in south China and AYVV was reported in A. conyzoides in Hainan Island, China (2). Therefore, this virus may pose a serious threat to tobacco production in south China. References: (1) Z. Li et al. Phytopathology 95:902, 2005. (2) Q. Xiong et al. Phytopathology 97:405, 2007. (3) X. Zhou et al. Arch. Virol. 146:1599, 2001. (4) X. Zhou et al. J. Gen. Virol. 84:237, 2003.

Magnetic and Electronic Properties of CaCu3Cr4O12 and CaCu3Cr2Sb2O12 by First-Principles Density Functional Calculation

The electronic and magnetic properties of CaCu3Cr4O12 and CaCu3Cr2Sb2O12 are investigated by the use of the full-potential linearized augumented plane wave (FPLAPW) method. The calculated results indicate that CaCu3Cr4O12 is a ferrimagnetic and half-metallic compound, in good agreement with previous theoretical studies. CaCu3Cr2Sb2O12 is a ferrimagnetic semiconductor with a small gap of 0.136 eV. In both compounds, because Cr4+ 3d (d2) and Cr3+ 3d (d3) orbitals are less than half filled, the coupling between Cr-Cu is antiferromagnetic, whereas that between Cu-Cu and Cr-Cr is ferromagnetic. The total net spin moment is 5.0 and 3.0 microB for CaCu3Cr4O12 and CaCu3Cr2Sb2O12, respectively. In CaCu3Cr4O12, the 3d electrons of Cr4+ are delocalized, which strengthens the Cr-Cr ferromagnetic coupling. For CaCu3Cr2Sb2O12, the doping of nonmagnetic ion Sb5+ reduces the Cr-Cr ferromagnetic coupling, and the half-filled Cr3+ t2g (t2g3) makes the chromium 3d electrons localized. In addition, the ordering arrangement of the octahedral chromium and antimony ions also prevents the delocalization of electrons. Hence, CaCu3Cr2Sb2O12 shows insulating behavior, in agreement with the experimental observation.

Electronic structures and chemical bonding in transition metal monosilicides MSi (M = 3d, 4d, 5d elements)

Bond distances, vibrational frequencies, electron affinities, ionization potentials, dissociation energies, and dipole moments of the title molecules in neutral, positively, and negatively charged ions were studied using the density functional method. Ground state was assigned for each species. The bonding patterns were analyzed and compared with both the available data and across the series. It was found that besides an ionic component, covalent bonds are formed between the metal s,d orbitals and the silicon 3p orbital. The covalent character increases from ScSi (YSi) to NiSi (PdSi) for 3d (4d) metal monosilicides, then decreases. For 5d metal monosilicides, the covalent character increases from LaSi to OsSi, then decreases. For the dissociation of cations, the dissociation channel depends on the magnitude of the ionization potential between metal and silicon. If the ionization potential of the metal is smaller than that of silicon, channel MSi+ --> M+ + Si is favored. Otherwise, MSi+ --> M + Si+ will be favored. A similar behavior was observed for anions, in which the dissociation channel depends on the magnitude of electron affinity.

Electronic structures and chemical bonding in diatomic ScX to ZnX (X = S, Se, Te)

Bond distances, vibrational frequencies, electron affinities, ionization potentials, dissociation energies, and dipole moments of the title molecules in neutral, positively, and negatively charged ions were studied using density functional method. Ground electronic state was assigned for each molecule. The bonding patterns were analyzed and compared with both the available data and across the series. It was found that, besides ionic component, covalent bonds are formed between the metal s, d orbitals, and the p orbital of S, Se, and Te. For neutral and cationic molecules, the covalent character increases from ScX to CrX and from FeX to CuX with an exception of decrease at MnX and ZnX, while for anionic molecules, the trend is not obvious. For both neutral and charged molecules, the sulfides have the shortest bond distance and largest vibrational frequency, while tellurides have the largest bond distance and smallest vibrational frequency. For neutral and anionic molecules, the dissociation energy of sulfides is the largest, that of tellurides is the smallest, while this only remains true for cationic molecules from ScX(+) to FeX(+).

Electronic structures and chemical bonding in 4d transition metal monohalides

Bond distances, vibrational frequencies, dipole moments, dissociation energies, electron affinities, and ionization potentials of MX (XM = Y-Cd, X = F, Cl, Br, I) molecules in neutral, positively, and negatively charged ions were studied by density functional method, B3LYP. The bonding patterns were analyzed and compared with both the available data and across the series. It was found that besides ionic component, covalent bonds are formed between the 4d transition metal s, d orbitals, and the p orbital of halogen. For both neutral and charged molecules, the fluorides have the shortest bond distance, iodides the longest. Although the opposite situation is observed for vibrational frequency, that is, fluorides have the largest value, iodides the smallest. For neutral and anionic species, the dissociation energy tends to decrease with the increasing atomic number from Y to Cd, suggesting the decreasing or weakening of the bond strength. For cationic species, the trend is observed from Y to Ag.

Influence of Mn-O-Mn bond angle on the magnetic and electronic properties in YBaMn2O5

The influence of the Mn-O-Mn bond angle on the magnetic and electronic properties of YBaMn(2)O(5) was studied by density functional theory, which was implemented in the CASTEP code. In practical calculation, both G- and A-type antiferromagnetic (AFM) orderings were considered. The calculated results indicated that G-type is more stable than A-type, in agreement with both experiment and previous theoretical study. It is also interesting to note that a transition from G-type to A-type at an Mn-O-Mn angle of ca. 170 degrees was found upon increasing Mn-O-Mn angle. Therefore, the calculation suggested that what is essential to stabilize the G-type AFM state is the reduction of the Mn-O-Mn bond angle. For both magnetic orderings, the compound changes from semiconductor to metal with the increase of Mn-O-Mn angle.

Density Functional Study of AuXq (X = O, S, Se, Te, q = +1, 0, −1) Molecules

Bond distances, vibrational frequencies, electron affinity, ionization potential, and dissociation energies of the title molecules were studied by use of density functional methods B3LYP, B3P86, B3PW91, BHLYP, BLYP, BP86, mPW1PW91, and PBE1PBE. It was found that the ground electronic state is doublet for neutral species, singlet for the anion, and triplet for the cation, in agreement with experiments and previous theoretical studies. The calculated properties are highly dependent on the functionals employed, in particular for the dissociation energy. The predicted bond distances and vibrational frequencies are in agreement with experiments and previous theoretical results. BP86 and BLYP have relatively good performance in reproducing the experimental results, while BHLYP is the worst functional method compared with the other density functional methods used for the title molecules.

Structural stability and electronic state of transition metal trimers

Ground state geometries were searched for transition metal trimers Sc3, Y3, La3, Lu3, Ti3, Zr3, and Hf3 by density functional methods. For all the studied trimers, our calculation indicates that the ground state geometries are either equilateral triangle (Zr3 and Hf3) or near equilateral triangle (Ti3, Sc3, Y3, La3, and Lu3). For rare earth trimers Sc3, Y3, La3, and Lu3, isosceles triangle (near equilateral triangle) at quartet state is the ground state. Isosceles triangle at doublet state is the competitive candidate for the ground state. For Zr3 and Hf3, equilateral triangle at singlet state is the most stable. For Ti3, isosceles triangle (near equilateral triangle) at quintet state gives the ground state. For Sc3, Zr3, and Hf3, where experimental results are available, the predicted geometries are in agreement with experiment in which the ground state is equilateral triangle (Zr3) or fluxional (Sc3 and Hf3). For Y3, the calculated geometry is in agreement with experimental observation and previous theoretical study that Y3 is a bent molecule for the ground state. For La3, our calculation is in excellent agreement with previous theoretical study based on density functional methods.